Description
UCLA HEALTH
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Description
Take
on a significant role within a world-class health organization. Elevate the
operational effectiveness of a complex health system. Take your professional
expertise to the next level. You can do all this and more at UCLA Health.
As
a key member of our Medicare Advantage
Operations team, you will develop detailed requirements specifications to meet
our business needs. This will involve working directly with and serving as a
liaison between business units, external trading partners, IT, and support
teams. You will:
- Ensure functional and non-functional
requirements are understood and implemented - Perform testing, design, and delivery
requirements - Identify, analyze, quantify, and
mitigate business risks - Deliver and update training
documentation - Generate ad hoc reports to support the operations
team
Salary Range: $76,200 – $158,800/annually
Qualifications
We’re
seeking a self-motivated, adaptable, customer-focused, results-driven
individual with:
- Required Bachelor’s degree in business, information systems, healthcare,
or a related field - Five or more years of experience managing enrollment, claims, or
encounters in a Medicare or managed care environment required - Five or more years of experience with CMS processes required
- Computer proficiency with Microsoft Office, SQL, and data
visualization tools - Knowledge of encounter
regulatory reporting and compliance requirements - Experience managing vendors to
contractual requirements - Ability to research and resolve encounter
issues - Understanding of the
healthcare model, capitation, and other managed care IPA and provider reimbursement
methodologies - Knowledge of physician/facility billing
practices, CPT coding initiatives, ICD-10 coding standards, and revenue
and HCPCS coding - Strong leadership,
interpersonal, analytical, problem-solving, and prioritizing skills - Excellent oral and written
communication skills - Ability to develop,
implement, and evaluate methods and systems to improve efficiency - Ability to work well
independently as well as part of a team
UCLA Health is a world-renowned health system with
four award-winning hospitals and more than 260 community clinics throughout Southern
California. We are also home to the David Geffen School of Medicine, a highly
respected leader in the development of breakthrough medical research and
outstanding clinical professionals. If
you’re looking to experience greater challenge and fulfillment in your career, you
can at UCLA Health.